| National Provider Identifier [NPI]: | 1689608010 |
| Last Name Of The Provider | JACOBSON |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | APNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 610 W ADAMS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLACK RIVER FALLS |
| Zip Code Of The Provider | 546159010 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 2573 |
| Number Of Medicare Beneficiaries | 168 |
| Total Submitted Charge Amount | 237170.5 |
| Total Medicare Allowed Amount | 45309.24 |
| Total Medicare Payment Amount | 34004.86 |
| Total Medicare Standardized Payment Amount | 39598.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 779 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 11759 |
| Total Drug Medicare AllowedAmount | 2253.06 |
| Total Drug Medicare PaymentAmount | 1908.08 |
| Total Drug Medicare Standardized Payment Amount | 1908.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 1794 |
| Number Of Medicare Beneficiaries With Medical Services | 168 |
| Total Medical Submitted Charge Amount | 225411.5 |
| Total Medical Medicare Allowed Amount | 43056.18 |
| Total Medical Medicare Payment Amount | 32096.78 |
| Total Medical Medicare Standardized Payment Amount | 37690.35 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 97 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9642 |